Johnson McDaniel Emergency Assistance Form
Do you identify as a person of color?
Are you currently receiving any of the following?
Housing assistance (DSS, ESG, Section 8)
Public Assistance/Cash Assistance
What is the dollar amount of financial assistance that you are requesting? Are you requesting it be paid directly to you or to a vendor?
Please provide details regarding your request for emergency assistance. Requests should not exceed $500.
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This form was created inside of Village At Ithaca.